Molnupiravir appears to work against Omicron as other variants: Study

New Delhi: The much-hailed anti-viral drug Molnupiravir is expected to work against the highly contagious Omicron as other variants of concern and more beneficial than monoclonal antibodies, according to a new study.

The study pointed out that no clinical studies are yet available to indicate effectiveness of molnupiravir in people infected with Omicron.

But, "subgroup analysis found molnupiravir was effective irrespective of strain although no data is available for its effect on Omicron in particular", stated the published in the journal, Diabetes & Metabolic Syndrome: Clinical Research & Reviews.

"Unlike monoclonal antibodies, the mechanism of action of molnupiravir is independent of mutations in the spike protein, and thus it is expected to work against Omicron, theoretically.

"Indeed, in vitro study of VeroE6-GFP cells does indicate that molnupiravir retain their activity against the VOCs of Alpha, Beta, Gamma, Delta, and Omicron."

The findings were jointly conducted by a team of doctors at Fortis C-DOC, G.D Hospital and Diabetes Institute, Jawaharlal Nehru Medical College and Hospital, and the Diabetes Foundation.

"In general, there is no doubt it is effective against Omicron, but yes it has not been tested," Dr Anoop Misra, Executive Chairman and Director, Diabetes and Endocrinology, Fortis C-DOC, told IANS.

Further, the study also stated that the antiviral molnupiravir may be much better than monoclonal antibodies and remedivisir.

According to the US Food and Drug Administration(FDA), Regeneron's Casirivimab-imdevimab are ineffective against the Omicron variant.

Also both remdesivir and casirivimab-imdevimab require hospital admission for infusion administration and need subsequent monitoring.

"Molnupiravir, on the other hand, can be used in out-patient settings through oral route with a lower cost," Mishra said, adding "these findings are very important in the context of India".

The study also proved that a 5-day course of Molnupiravir could reduce deaths and prove effective and safe at relatively lower costs, in adults and non-pregnant Covid-19 unvaccinated patients at increased risk of severity or needing hospitalisation.

"It doesn't seem to have any major side effects," Mishra said.

However, Mishra warned against the "inappropriate and injudicious use in too many individuals without assessing risk".

He also noted in the study that the "benefit ratio may pose an unknown long-term risk of theoretical public concern".

The study recommends the use of molnupiravir in adults above 18 years, and in non-pregnant women.

Females with childbearing potential must use a reliable method of contraception during the entire duration of treatment and for 4 days after the last dose of molnupiravir.

Also, males having reproductive potential must use a reliable method of contraception during treatment and for at least 3 months after the last dose of molnupiravir.

"From the available evidence, Molnupiravir appears to be a reasonably useful drug in reducing deaths and hospitalisation in adult patients with Covid-19 having high risk, with a relatively lower cost," Mishra said, in a statement.

It "could be a useful drug in non-pregnant unvaccinated adults with Covid-19 who are at increased risk of severity including hospitalisation," he added.

Developed by US-based drug company Merck, Molnupiravir is approved by the US Food and Drug Administration against Covid-19.

India has also approved the drug amid rising cases of new Covid variant Omicron in India. An expert panel of the Central Drugs Standard Control Organisation recently approved the antiviral Molnupiravir for restricted use in emergency situations. The antiviral drug will be manufactured by 13 companies in India.